TM Owner Sanofi
Taxotere 20mg/0.5ml Injection
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Indications & Clinical Uses
- Taxotere (docetaxel) 20 mg/0.5 mL injection concentrate is a taxane chemotherapy from Sanofi given only as a hospital-supervised intravenous infusion, never self-administered.
- It is approved for locally advanced or metastatic breast cancer, alone or combined with doxorubicin and cyclophosphamide as adjuvant therapy; non-small cell lung cancer, alone after platinum-based chemotherapy failure or combined with cisplatin in previously untreated patients; metastatic castration-resistant prostate cancer with prednisone; advanced gastric adenocarcinoma with cisplatin and fluorouracil; and locally advanced squamous cell carcinoma of the head and neck with cisplatin and fluorouracil.
- Docetaxel is chemically and clinically distinct from paclitaxel (Taxol) - the two taxanes are not interchangeable and have different dosing, premedication, and toxicity profiles.
- Premedication with an oral corticosteroid for three days is required before each infusion to reduce fluid retention and hypersensitivity.
Side Effects
- Taxotere carries a boxed warning covering treatment-related toxic deaths, hepatotoxicity, severe neutropenia, hypersensitivity reactions, and fluid retention, all more likely with abnormal liver function or higher doses.
- Neutropenia is very common, affecting almost all patients and requiring frequent blood counts, and severe hypersensitivity reactions can occur despite steroid premedication.
- Fluid retention causing swelling, weight gain, or fluid around the lungs affects roughly two-thirds of patients and can persist or worsen with repeated cycles.
- Other very common effects include fatigue, hair loss, mouth soreness, nausea, and numbness or tingling in the hands and feet.
- Skin and nail changes are also common.
- Seek urgent medical help for fever, breathing difficulty, swelling, severe rash, or signs of infection.
Precautions & Warnings
- Taxotere must be avoided if bilirubin is above the upper limit of normal, or if liver enzymes and alkaline phosphatase are both significantly elevated, because of increased risk of toxic death.
- Treatment should not start if the neutrophil count is below 1,500 cells/mm3.
- Liver function, full blood counts, and signs of fluid retention should be checked before and during every cycle.
- Docetaxel causes fetal harm and must not be used in pregnancy; effective contraception is required during treatment and for a period afterward for both female and male patients.
- Peripheral neuropathy, skin reactions, and cardiac effects should be monitored, with dose reduction or discontinuation if severe.
- Taxotere is for intravenous infusion only, given over about one hour under specialist supervision, and vials must never be given as a rapid push or bolus.
Avoid Interactions
- Docetaxel is metabolised mainly by CYP3A4, so strong inhibitors such as ketoconazole, itraconazole, clarithromycin, ritonavir, and grapefruit juice can markedly increase docetaxel exposure and should generally be avoided; if unavoidable, close monitoring or a dose reduction is needed.
- Strong CYP3A4 inducers, including rifampin, carbamazepine, and St John's wort, can reduce its effect.
- Combining Taxotere with other bone-marrow-suppressing chemotherapy increases the risk of severe neutropenia and infection.
- Live vaccines should be avoided during and after chemotherapy because of reduced immune response.
- Because of overlapping hepatotoxicity risk, alcohol and other liver-affecting medicines should be used cautiously.
- Always tell your oncology team about every prescription, over-the-counter, and herbal medicine you take before each cycle of Taxotere.
References
Frequently Asked Questions
Taxotere (docetaxel) treats breast cancer, non-small cell lung cancer, castration-resistant prostate cancer, gastric cancer, and head and neck cancer, often combined with other chemotherapy drugs such as cisplatin or prednisone. It's a taxane, chemically different from paclitaxel (Taxol), and the two are not interchangeable.
Taxotere is given as a roughly one-hour intravenous infusion by a cancer specialist in a hospital or clinic, never self-administered. You'll take an oral steroid for three days, starting the day before infusion, to reduce fluid retention and allergic reactions.
Taxotere carries a boxed warning for toxic deaths, liver injury, severe neutropenia, hypersensitivity reactions, and fluid retention. Very common effects include low blood counts, fatigue, hair loss, mouth soreness, and numbness in the hands and feet. Seek urgent help for fever, breathing trouble, or severe swelling.
Avoid strong CYP3A4 inhibitors such as ketoconazole, clarithromycin, and grapefruit juice, which raise docetaxel levels, and inducers like rifampin, which reduce its effect. Taxotere is not safe in pregnancy for either partner. Tell your oncology team about every medicine and supplement you use.
After steroid premedication, Taxotere is infused over about one hour while staff monitor for allergic reactions and fluid retention. Blood counts and liver function are checked before each cycle, and the next dose may be delayed or reduced if neutrophils are too low.
Unopened Taxotere vials are stored at room temperature, 2C to 25C, protected from light - they are not routinely refrigerated at 2C to 8C. Storage and preparation are handled entirely by the pharmacy and clinic; patients never store or handle Taxotere themselves.
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